Mozambique

Abstract

The chapter highlights areas that deserve attention to protect vulnerable citizens, including strengthening local-national mechanisms of communication/accountability and clarifying criteria used for decision-making on equitable policies. Also noted are the inappropriate use of funds, unequal fund allocation to the provinces, reduction of funds to social protection and weak inclusive governance. Good practices include the Government of Mozambique’s issue of update reports and the role assigned to the National Institute of Health, enabling greater emphasis on evidence-based/scientific data. Recommendations include a broader perspective on social protection (to help tackle gender and human rights challenges); strengthening focus on informal economy; well-coordinated intersectoral policies (considering health, food, economic, social and security ‘multiple crises’); fair/transparent prioritization criteria for vaccination; policy strategies to guarantee that social protection benefits reach most vulnerable groups and ensuring that COVID-19 response invested resources contribute to poverty alleviation/inclusive growth; and compiling report of all measures implemented (governmental and non-governmental).

Introduction

The socioeconomic shocks caused by the COVID-19 pandemic have brought the debate on income distribution/redistribution and social protection to the centre of the public agenda. In Mozambique, this topic is especially relevant because of the cyclical and structural context, which is characterised by multiple crises, including poverty¹ and economic, social, gender, and regional inequalities; food insecurity and chronic malnutrition; lack of confidence on the part of development cooperation partners (including as a result of the ‘hidden debts’² Scandal and lack of progress in good governance); the unsustainable level of external public debt, which has led to a sharp depreciation of the national currency (Mozambique metical) against the US dollar (CDD, 2020b); and political-military instability in the central region of the country and the insurgency (including violent extremists) in the province of Cabo Delgado (Presidência da República, 2020). In addition, the crisis generated by the COVID-19 pandemic, mixed with these structural crises, weakens the government’s ability to respond to the socioeconomic shocks caused by the COVID-19 pandemic (CDD, 2020a), which has led to the partial paralysis of many economic activities, leading to the closure of companies, increased unemployment, and increased cost of living.

Data from the National Statistics Institute (2020) for April to June 2020 revealed that, because of the measures adopted to curb the COVID-19 pandemic, 62,700 workers were affected by the suspension of contracts. Another 77,489 workers were affected by the termination of contracts, and 43,579 by the closure of companies. In addition, an inquiry made by the Association of Trade, Industry and Services (Associação de Comércio, Indústria e Serviços, ACIS) found that Mozambican companies had registered a 60% drop in sales due to the impact of COVID-19 (República de Moçambique, n.d.). As a result, the Government of Mozambique was called upon to establish a long-term approach to tackling the pandemic. The mitigation strategies should enable structural changes in the economy in the long term.

The study’s main objective was to analyse Mozambique’s national COVID-19 response in terms of policy coherence from an equity perspective, focusing on policies/measures that formally target the most vulnerable groups.

Mozambique’s COVID-19 Situation

This case study addresses two ‘waves’ of the COVID-19 pandemic in Mozambique: the first covering nine months from March to November 2020 and the second from late December 2020 to the time of writing (February 2021). It is essential to remember that Mozambique is currently facing a State-citizen crisis, in which part of the population lack trust in the central Government for various reasons, including the ‘hidden debt’ scandal, which is an important context to consider in the analysis. Considering this, before December 2020, the existence of COVID-19 was unclear to most of the population. During the first wave, individual prevention practices relied mainly on the population’s limited trust in the information shared by the Government and their willingness to follow the government’s state of emergency/calamity decrees. On top of this, fake news spread through informal channels and social media posts made some people believe that COVID-19 would not spread in Mozambique.

The analysis notes that the worsening of the COVID-19 pandemic in Mozambique has been associated with two phenomena (Tibana, 2021): the relaxation of prevention measures announced by the Government on December 17, 2020, and the penetration of the South African strain of the virus in November 2020, which is considered more infectious and lethal. As a result, as illustrated in Fig. 10.1, the number of COVID-19 cases has increased significantly from December 2020 to February 2021.

Fig. 10.1

Source Based on Worldometer (https://www.worldometers.info/coronavirus/country/mozambique/); and Mozambican National Institute of Health)

Cumulative COVID-19 cases in Mozambique (March 2020 to February 2021).

The increase in cases preoccupied the national health system, as health facilities are not equipped to deal with the volume of people needing treatment, as noted in the President’s speech on February 4, 2021, (Presidência da República, 2021). Since March 2020, debates have intensified about the dilemma faced by the Government, namely, the need to implement a ‘total lockdown’ to contain the spread of COVID-19 and relieve the pressure on the health system versus the need to keep the economy running to some extent. Some actors have argued that while it is crucial to ensure economic stability, saving human lives and caring for the most vulnerable sectors of the population should also be a priority. However, the debate as to whether a lockdown should be applied is not unanimous. In addition, civil society has no formal channel to be involved in such debates and decisions related to COVID-19 policies. It was due to this situation that many civil society organisations (CSOs), such as the Budget Monitoring Forum (FMO), Mozambican Civil Society Platform for Social Protection (PSCM-PS), women’s organisations and non-governmental organisations (NGOs), prioritised monitoring the implementation of COVID-19 policies. They also conducted equity-related advocacy campaigns and research, arguing that the main focus of efforts should be to protect the most vulnerable population groups.

COVID-19 Mitigation in the Provinces

COVID-19 exacerbated existing crises. For instance, since 2017, the province of Cabo Delgado, where Pemba is located, has faced violent extremism, which has resulted in an estimated 530,000³ internally displaced persons (IDPs) fled to cities where people were already facing multiple crises (i.e., low food supply, unemployment, climate change and others). Sofala province, where the City of Beira is located, was one of the regions most affected by Cyclone Idai in March 2019, which destroyed houses, infrastructure, and production units, thus increasing the number of vulnerable citizens in need of support from government social protection programmes. Although, so far, the epicentre of the COVID-19 pandemic has been Maputo, the capital of Mozambique (Presidência da República, 2021), transmission has been increasing in other parts of the country. As a result, health facilities specially equipped to treat people with COVID-19 have been built/repurposed in provincial capitals. However, if the recent rapid rise in cases (second wave) seen in the capital carries over to the provinces, health facilities are unlikely to be able to cope with the demand for COVID-19 treatment services.

National Social Protection System

On March 30, 2020, a State of Emergency was declared throughout Mozambique (Presidential Decree No. 11/2020) to allow the Government to implement measures to combat the spread of COVID-19. The Minister for Gender, Children, and Social Action—MGCAS (2020a)⁴, advised the INAS (National Institute of Social Action) and the Provincial Social Affairs Services to implement a sectorial plan at the national level to mitigate the negative socioeconomic impacts on the most vulnerable population groups in Mozambique, because of the measures taken to control the spread of the virus (UNICEF & ILO, 2020).

Basic Social Security is provided by INAS through the following programmes (República de Moçambique—Sistema de Protecção Social, 2019a):

• Basic Social Subsidy Programme (PSSB) and Productive Social Action Programme (PASP)—cash transfers;

• Direct Social Support Programme (PASD)—food vouchers, in-kind transfers, service payments;

• Social Action Social Services Programme (PSSAS)—assistance in social units and social services.

For the COVID-19 pandemic, however, non-contributory social protection is primarily covered by external funds (MGCAS, 2020a), as it is assumed that State funds for emergency purposes are unavailable.

Methodology and Analytical Framework

The case study used the data triangulation technique, based on a combination of methods as illustrated in Fig. 10.2 and Table 10.1.

Fig. 10.2

Four phase methodology

Table 10.1 Data collection methods and techniques applied in each phase

Data analysis was based on qualitative techniques, as the surveys used an exploratory approach to COVID-19 pandemic policies and their effectiveness in the field. As for sampling, because this was a qualitative study, techniques such as convenience sampling were used to identify respondents. The primary data collection process ended in November 2020, and COVID-19 statistics were updated until the end of February 2021.

Analytical Framework

The analytical framework for this study is an adaptation of the ‘policy’ coherence for development—PCD (Cadernos de Estudos Africanos, 2017) through a perspective of ‘equity’. The PCD principle helps assess to what extent specific policies (in this case, the COVID-19 response) contribute to the broader policy objectives of the National Development Strategy of Mozambique, namely combating poverty and promoting inclusive development. The applied policy coherence approach relates directly to the Government’s Five-Year Plan (approved by the Assembly of the Republic and annually transformed into the social, economic plan and state budget) and to the way society organises its power structures to solve development challenges and the State organises itself to protect vulnerable groups. Considering that exclusion and human rights violations become more severe in times of crisis, addressing this question is even more relevant during the COVID-19 pandemic.

The perspective of equity is a lens that pays attention to social justice.⁵ Whereas ‘equity’ has been chiefly applied to public policies on gender, it needs to be better understood as an inclusive policy approach to guarantee social justice. The Social Action Policy and its Implementation Strategy (Resolution 46/2017, November 2) include ‘Social Justice’ as a principle. Therefore, when the Government designed the COVID-19 Response Plan for social protection, there was an implied commitment to formulating equitable policies.

Policy coherence, combined with an equity lens, is also about questioning the centralisation of budget resources and focusing on justice in the distribution of resources. These lenses look at how public policies are formulated—to what extent they are participatory and based on context evidence and data gathered by trusted and independent entities. Effective participation is a crucial indicator of equity, related to the presence (or lack) of social justice and opportunities for the most vulnerable groups to access information and participate in decision-making processes. This approach can also benefit from a search for transparent mechanisms for sharing information and implementing monitoring and evaluation systems.

Measures: Planned Response to COVID-19, Budget, and Allocation to Social Protection

COVID-19 Response Plan (PRC19).

The Government of Mozambique had taken a series of measures to combat the pandemic since mid-March when the first case was recorded. One of the most significant was the declaration of a State of Emergency (MEF, 2020a). In parallel, and to respond to the direct and indirect (potential) impacts of COVID-19, the Government recognised the need to support different sectors (health, social protection, and the private sector) and State revenue, among other things (MEF, 2020b).

Public Budget

The Ministry of Economy and Finance estimated that the activities and actions under the COVID-19 Response Plan (PRC19) would cost around USD 700 million (about 5% of Mozambique’s GDP, compared to a world average of 3.7%) (BBC, 2020). The Government’s budget for the PRC19 is set out in Table 10.2.

Table 10.2 The government budget for COVID-19 Response Plan (USD)

An equity lens notes that around a third of the total PRC19 budget (approximately USD 240 million) was allocated to ‘Transfers to families, to guarantee social protection to the most vulnerable households during the pandemic’. Hence, this appears to be the highest priority in allocating funds (34% of funds). ‘Micro businesses’ are also targeted (with 23% of funds). The budget allocated to the health sector (14% of funds) also impacts the most vulnerable groups, who rely on the national health system.

Due to the budget deficit, which is mainly the high debt servicing required because of the unsustainability of Mozambique’s internal and external public debt (CDD, 2020c), and what happened when the country was hit by cyclones Idai and Kenneth in 2019, the Government requested USD 700 million to finance the plan from development cooperation partners. However, the lack of confidence of development partners in the Government, caused by the ‘hidden debt’ scandal and the lack of progress in good governance, particularly in combating corruption and promoting transparency and accountability, hampered the Government’s ability to obtain financial support. However, despite this, the Government managed to mobilise significant resources through loans and grants. For example, through its USD 309 million credit approval document to contribute to the PRC19 budget, the International Monetary Fund (IMF) expressed a desire to see its financing (as a conditional loan) not only help Mozambique in the fight against COVID-19 but also to have a catalytic effect on Mozambique’s other development partners (IMF, 2020). For this reason, the IMF incorporated transparency and accountability mechanisms into the agreement, including the publication of large public procurement contracts and the carrying out and publication of audits.

Complementary Funds

From the perspective of transparency in policy coherence, it is essential to recall that the PRC19, provided by the Government in its Status of Commitments under COVID-19 (MEF, 2020b), does not explicitly mention other types of support, such as programmes (i) financed by the private sector and operated by the Government; (ii) financed by external funds and operated by the Government (not directly included in the state budget); (iii) financed and operated by development cooperation partners and coordinated by the Government; (iv) financed, operated, and coordinated by development cooperation partners; or (v) financed and operated by civil society and the private sector. In addition, other programmes were implemented in coordination with the Government. Some of these were not included in the PRC19 mentioned above.

Social Protection Response

A sectoral budget analysis of the Social Action sector (which includes a specific chapter on the Social Protection Response Plan to COVID-19—PRC19-PS) states that ‘The ambitious Social Protection Response Plan to COVID-19 in Mozambique, if implemented in its entirety (…) would imply an unprecedented extension of the social protection system coverage, both at the national level and in the sub-Saharan Africa region, adding, even if temporarily, almost 1 million new vulnerable beneficiaries not yet included in the non-contributory system managed by INAS’ (UNICEF & ILO, 2020, p. 15). The brochure COVID-19 Response Plan—Social Protection (June 2020) also highlights the ambitious nature of this plan and notes that to ensure its implementation, the Ministry of Gender, Children, and Social Action was coordinating efforts with various Government partners (see MGCAS, 2020b for details).⁶

In general terms, the PRC19-PS is anchored in the current framework of the National Basic Social Security Strategy II (ENSSB II), which allows social protection programmes to be activated in ‘emergency scenarios’ (MGCAS, 2020b). However, the plan also encompasses actions considered ‘innovative’, including an objective selection of programme implementation sites, information management system; digitalised payments to beneficiaries; comprehensive programme coverage; and identification of new beneficiaries.

Cash Transfers

A core strategy of the Social Protection Response is to adapt the current Basic Social Security programmes managed by INAS to make cash transfers available. Accordingly, the Ministry of Gender, Children, and Social Action clarified this measure as non-contributory social protection implemented through external funds and that, in addition to making cash transfers available to new beneficiaries (for six months), three-month cash transfers were also forecasted for current beneficiaries of the PSSB (Basic Social Subsidy Programme) and PASP (Productive Social Action Programme) (MGCAS, 2020b).

The criteria defined by the MGCAS (October 2020) for receiving cash transfers are households in situations of poverty and vulnerability and households living in urban, peri-urban and border areas, with priority given to households headed by: older people, people with chronic and degenerative diseases, people with disabilities, children, pregnant women without a source of income, and women with six or more dependents. In addition, households that host internally displaced persons are also given priority.

In addition to the criteria for households, the following socioeconomic categories were identified as priorities for pandemic response measures/policies: internally displaced people/refugees; disabled people; children under challenging situations; older people in absolute poverty; disabled people in absolute poverty; people with chronic and degenerative diseases; people benefiting from Basic Social Security programmes; women/women heads of households; and people living on the streets (MGCAS, 2020a).

In-kind Social Protection Measures

The Ministry of Gender, Children, and Social Action foresees the allocation of a food basket corresponding to three months of food to existing beneficiaries through the PASD (Direct Social Support Programme) for 18,438 current beneficiaries. In addition, other in-kind benefits are related to providing hygiene and personal protection equipment to vulnerable people, technicians, and employees, totalling 600,000 beneficiaries (provision of hygiene material) and 1.6 million beneficiaries (provision of individual protection material such as masks). These are also non-contributory social protection programmes implemented through external funds (MGCAS, 2020a).

Credit for Small and Medium Enterprises

The Government created a credit line to support small and medium enterprises (SMEs).⁷ On July 1, 2020, the National Investment Bank (BNI), the Mozambican bank for development, proceeded with the launch of two special credit lines with 100% state capital: (i) the ‘Gov. COVID-19 Credit Line’, with USD 15 million funded by the IMF through the state budget, and (ii) the ‘BNI COVID-19 Credit Line’, with USD 9 million funded by the INSS. The BNI created the Special Credit and Evaluation Committee to approve proposals for financing, with a total of 900 proposals received and 151 approved worth USD 18,975,000.

Although there is a need for a more in-depth analysis of selected SMEs (i.e., in terms of the equity of the selection criteria), the Government’s focus on SMEs is justified by the fact that they absorb the most significant part of the active workforce, represented mainly by low-income young people with a low level of academic and technical-professional training. Financial support for SMEs in this context can be an indirect way of protecting vulnerable groups who are dependent on employment by SMEs. The government initiative to protect SMEs supported the Confederation of Economic Associations (the largest association in the Mozambican private sector). However, the challenges identified include adequately reaching vulnerable groups, as the implementation of these plans is still deficient.⁸

Support for the Informal Sector

Another issue that has hampered the efficient implementation of social protection programmes in the context of COVID-19 is the high level of informality in the economy. In this regard, support was provided to low-income self-employed workers by promoting their affiliation with the INSS (ILO, 2020). In addition, ILO also conducted A Rapid Assessment of the Impact of COVID-19 on the Informal Economy in Mozambique (ILO, 2020) with recommendations to mitigate the negative socioeconomic impacts of COVID-19 on workers in the informal economy.

The Social Protection Response does not explicitly include measures to subsidise the cost of electricity, gas, water, or public transport (MGCAS, 2020a). Although it is known that some of these measures are being implemented, it is not clear the source of the funds (private and/or public) or which sector is accountable for such interventions. In addition, it should be noted that policies in the health and education sectors, implemented in response to the COVID-19 pandemic, despite not being included in social protection actions, also benefit the most vulnerable groups in the population.

Policy Coherence and Equity of Social Protection Response to COVID-19

As shown in Table 10.2, in requesting financial assistance from the international community, social protection was the top priority of the Government of Mozambique in its plan to mitigate the effects of COVID-19. Table 10.3 provides an update, up until December 2020, showing that out of a total of USD 700 million, development partners had disbursed approximately USD 662 million.

Table 10.3 The government budget for COVID-19 response (USD) up to December 2020

In the follow-up report, Status of Commitments under COVID-19—Maputo (December 2020), two inconsistencies can be identified, which require further attention:

• Although the periodic dissemination of information was acknowledged as a good practice, the updates report only on the funds received by the Government to implement its response plan to COVID-19. They did not report on every fund applied in response to COVID-19 in the country. The response to COVID-19 in Mozambique included interventions by development cooperation partners, whose actions have the same objective.

• The shift in budget prioritisation weakens the original focus on targeting vulnerable groups—it is concerning to see (through the comparative data on budget allocation per sector in 2020) an apparent decrease in the budget funds for social protection targeting vulnerable groups (funds allocated to transfers to households).

By comparing the initial plan and the most updated data (December 2020), we see that the initial allocation to the social protection sector was the highest priority, with a relative weight of around 34% (USD 240 million) of the total financing volume. However, of the total amount disbursed to date (USD 661.5 million), only 7% (USD 38.9 million) has been channelled to social protection (Fig. 10.3).

Fig. 10.3

Source MEF (2020c, December)

The relative deviation between the planned and actual allocation of funds. Note MGCAS = Ministry of Gender, Children and Social Action; OE = State budget; BNI = National Investment Bank.

The budget signals a change in the Government’s understanding of the allocation priorities for COVID-19, which has sacrificed the funding provided to protect vulnerable households from financing the state budget above what was initially planned. However, explanations for this shift were not provided in the analysed reports. As the social protection benefits refer to cash and in-kind transfers, not prevention or treatment, the fact that the number of cases (by December 2020) had not been as high as initially expected cannot be a reason for the diminished support to vulnerable households, most of which were highly affected by the economic impact of the COVID-19 pandemic.

Inappropriate Use of Funds

Since August 2020, the Budget Monitoring Forum has been assessing the policy coherence of the Government’s interventions under the COVID-19 Response Plan, including monitoring the procurement processes carried out and tracking expenditure. Below are the core findings and recommendations from FMO for better public finance management, particularly within the response to COVID-19 (FMO, 2020):

The key findings showed that not all work carried out by the Ministry of Public Works, Housing and Water Resources was submitted for the inspection process, and about 99.97% of the funds allocated to the Ministry were spent in the form of direct adjustments.⁹ There seems to be excessive use of the funds by the Ministry through the direct award method, even in cases where it was possible to purchase goods and services in good time.

In the health sector¹⁰out of the total funds allocated to the Ministry of Health, about 67.1% were allocated to the central level, 31.4% to the provinces, 0.8% to the National Institute of Health, and 0.7 to Maputo Central Hospital. About 84% of the funds allocated to the Ministry of Health to prevent and combat COVID-19 at the provincial level were spent on food and accommodation expenses for health professionals in hotels in the provinces of Nampula and Maputo (MZN 25 million and MZN 10.8 million, respectively).

The transport sector (investment in public transport) does not appear in any plan/budget for the mitigation of the impacts of COVID-19. However, for individuals who depend on overloaded public transport to go to and from work (formal or informal), transport presents a significant risk of contracting COVID-19. This daily risk makes the other individual prevention measures less effective (FMO, 2020). Through an equity lens, the findings of FMO bring to light, among other things, the fact that:

• Establishing fair criteria based on the evidence of the needs of the most vulnerable groups should be at the core of an equity-oriented planning process.

• Rationality in the use of resources is crucial to guarantee equitable policies. Conscience about budget expenditure is a core ethical value of social justice, as funds allocated to social areas can substantially contribute to people’s lives.

• The decentralisation of expenditure execution is key to inclusion, the equitable distribution of resources, and the reduction of regional/urban–rural inequalities.

Equity in Budget and Implementation

An analysis of the equity of the budget for the Social Action sector reminds us that (UNICEF & ILO, 2020):

• As social protection programmes target poor and vulnerable populations,¹¹ the most critical allocations from the sector should be directed to the provinces with a higher percentage of poor and vulnerable households. However, while allocations from social protection programmes to the most disadvantaged provinces have increased nominal, per-capita allocations are not yet equitable.

• The country’s poorest provinces¹² continue to receive the highest nominal allocations from the INAS social protection programmes. However, allocations to provinces with the country’s highest poverty rates are still insufficient to meet the enormous needs of their vulnerable populations. As for geographical equity, in terms of per-capita allocation among the poor population, the three poorest provinces receive the lowest allocation.¹³

The analysis of local actors and community-based organisations (CBOs), based on their concrete experiences, also points to significant structural challenges that prevent policies from effectively reaching the most vulnerable groups in all parts of the country. The following examples are based on the data collected from CBOs in the Beira and Pemba:

• Difficulties in accessing and disseminating correct and inclusive information (e.g. on people with disabilities) to communities and beneficiaries;

• Weak knowledge on the part of local leaders about the population, especially vulnerable communities;

• Current practices of corruption, sexual harassment, and poor policy transparency;

• Poor dissemination of information on social protection benefit packages to beneficiaries;

• Poor understanding by beneficiaries of their rights and responsibilities;

• Lack of inclusion of representatives of vulnerable groups in monitoring mechanisms;

• Poor coordination between Government and CBOs;

• Instability due to violent conflict.

Justice and Transparency in Targeting Criteria

Given that the COVID-19 pandemic context has restricted access to resources and exacerbated historical and structural socioeconomic inequalities, the definition of criteria for prioritising social protection policies has become a vital issue. The task of prioritising certain groups of beneficiaries over others (who may also be vulnerable) or focusing on measures targeting the ‘poorest of the poor has proved to be ethically complex, requiring focused attention’. As addressed above, the Government has identified a list of vulnerable groups but has not clarified the criteria for prioritising the ‘most vulnerable groups in its response to the pandemic’. Also missing was an intersectionality approach (to look at multiple inequalities and discriminations) to identify persons/groups that belong to more than one social category or have more than one condition that creates barriers to access to resources and services. Examples based on the Pemba, Beira, and Maputo contexts include the importance of paying specific attention to:

• People with disabilities who, in addition to tending to be economically vulnerable, may encounter barriers to access to information and services.¹⁴

• Internally displaced persons (IDPs) who, in addition to typically facing severe economic vulnerability, may also suffer from inclusion barriers linked to gender, religion, ethnicity, age, disability, chronic illness, or other inequalities, as well as IDP women who may have specific needs (e.g., access to sexual and reproductive health services).¹⁵

• Women heads of households can be more vulnerable to sexual violence (domestic or in public spaces), which adds to their economic vulnerability, and can have other vulnerabilities linked to gender inequalities.

Hence, beneficiaries can be identified using diverse factors. For example, economic condition (serves as a defining criterion for the choice of households in poverty, although the definition of poverty does not consider only family income), geographical locality (households/population living in urban, peri-urban and border areas), social inequality (based on gender, ethnicity/race, age, women-headed household, elderly, children), and/or health/biological conditions (chronic diseases and disabilities among others). Conditions of emergency, whether due to violent conflict or climate crises, can result in the creation of new categories of beneficiaries, such as internally displaced persons.

Equity With Regard to Health

Another gap identified relates to equity regarding the budget for health and the identification of target groups in terms of health. As noted through the shared experience of the Citizen Observatory for Health (Observatório Cidadão para a Saúde), there is a need to enhance strategies to reach out to vulnerable groups with chronic diseases or others who may depend on domestic medical support during the pandemic.¹⁶ With regard to the expenditure by the Ministry of Health, analysis shows that the distribution of funds among provinces has been uneven, and government follow-up reports have not explained the criteria used to determine the amounts to be allocated to each province or the criteria used to allocate 67.1% to the central level and 31.4% to the provinces (FMO, 2020). Noteworthy, although the pandemic can potentially affect anyone, its impact is also determined by inequalities. The definition of criteria becomes a core mechanism for decisions, including prioritisation during the vaccination process.

Expansion of Coverage and Decrease in Planned Investment

As already pointed out, although the PRC19-PS was considered ‘ambitious’ (in terms of its expansive coverage), there have been decreased financial resources necessary to fulfil the desired goals. Still, even when funds are available, an equity lens calls attention to the need to expand the spectrum from a narrow perspective focused on quantitative goals to the broader aim of pursuing the goal of social justice and qualitative impacts.

Collected data also reinforced that the Government has limited capacity to protect its vulnerable population.¹⁷ In social protection policies, numbers refer to human beings; therefore, quantitative and qualitative results should go together. If the Government sets a plan that is ambitious in terms of the number of beneficiaries, qualitative equity measured by indicators (i.e., equitable distribution of resources, justice in the definition of policy criteria, affirmative action defined according to evidence-based data, multiple inequalities and discriminations, inclusive and transparent governance mechanisms, among other things) is also necessary.

Gender Inequality and Vulnerability of Women and Girls

One of the principles of the Social Action Policy is gender equality and equity (República de Moçambique, 2017). However, research¹⁸ carried out by Women and Law in Southern Africa (WLSA), called attention to key gender equity challenges, including in relation to women’ access to health and informal labour market, in the context of the COVID-19 (WLSA, 2020).

The Women’s Forum has also prepared a ‘Positioning of Women and Girls’ (Mulher, 2020a) at the beginning of the COVID-19 pandemic (April 7, 2020). Recommendations included; circulating relevant information (disseminated in several national languages and through various means), validated by the scientific community, on the risks posed by the COVID-19 pandemic and the preventive measures that individuals, in particular girls and women, can and should take; to create an emergency telephone number to report or call for help in cases of violence; to establish (legal and social) rules for the protection of employment, among others.

Role of CSOs and CBOs in Monitoring of National Response

The present analysis has identified the absence of participation by civil society organisations in the multi-sectoral Technical and Scientific Commission created to advise the Government on the COVID-19 response policies and measures. The fact that the role of civil society is not understood and/or valued deserves further reflection, as this sector has vast knowledge about the needs of the most vulnerable groups and can play a crucial role in providing support to ensure the equity of COVID-19 policies and plans.

However, in theory, the Government recognises the crucial role of CSOs in monitoring and identifying potential beneficiaries to be enrolled in the PASD-PE ‘COVID-19’, as well as channelling complaints and claims by beneficiaries (MGCAS, 2020b, p. 2). At the meeting on ‘The Role of CSOs in the consolidation of the Social Protection Response Plan to COVID-19 in Mozambique’, it was also noted the preeminent role of civil society in mapping, identifying, and registering people eligible for post-emergency social support as well as the advance submission of lists of potential beneficiaries to the INAS.¹⁹

Specific roles of CSOs mentioned included: advocacy and policy influence, accountability, denouncing, proposing, and supporting government action for prevention and awareness raising and translating and ensuring that reliable information reaches communities.²⁰

When assessing their role, CSOs and CBOs at the provincial level (both in Beira and in Pemba) stressed that they face several challenges in fulfilling their role. The main barrier highlighted is the lack of access to information about the Government’s COVID-19 Response Plan and its benefits for vulnerable groups. Access to this information was noted as essential for monitoring and channelling complaints. It identified various civil society actions that carried out actions and research-oriented monitoring and accountability. For instance, the Mozambican Budget Monitoring Forum (FMO)²¹ advocates for transparency and accountability in public finances, particularly on the issue of public debt. FMO implemented the initiative ‘Response to COVID-19 with Right Accounts’ to ensure that the resources to mitigate the effects of the COVID-19 pandemic are being effectively applied and that the response is coherent and compelling. Other CSOs such as the Centre for Democracy and Development (CDD), the Rural Observatory (OMR), Center for Public Integrity, the Institute of Social and Economic Studies(IESE), and the Independent Community Monitoring (MCI) project played roles in the research, monitoring and advisories on issues to do with social protection for the vulnerable among others.

Conclusion and Recommendations

The chapter presents an analysis of the COVID-19 response by the Government of Mozambique in terms of policy coherence and equity. The analysis has highlighted many areas that need attention to protect vulnerable citizens. This chapter draws conclusions and makes recommendations, including areas for further study.

Suitability of Measures and Proportionality of Response

Based on an assessment in terms of the planning and allocation of resources, it can be concluded that the government measures in response to COVID-19 have, up until December 2020, failed to strongly prioritise social protection, as committed to by the Government in the original budget plan. Given that the state budget deficit was a reality (which could not be solved in the short term), the decision to ask for external aid or loans was appropriate. However, as analysed by FMO, how the funds were used was not appropriate, especially since the misuse and/or inefficient use of funds has had a direct negative impact on the most vulnerable groups to which the funds could have been channelled.

On the impact of social protection policies, it is recommended that further follow-up/evaluation be conducted on the following:

• Government budget planning and updates have so far failed to explain the criteria (and data/evidence underpinning such criteria) used for decision-making about areas to prioritise and the amount of funds to allocate. There is a need to evaluate to what extent the decision to adapt the existing policies to the context of COVID-19 has led to the support of the groups most vulnerable during the pandemic.

• As noted by CBOs (in Beira and Pemba), the lack of information provided to CBOs and beneficiaries about the planned social protection benefits under the Government’s PRC19 indicates the need for an assessment of the extent to which the transfers to families were effective in reaching the groups most impacted by COVID-19. In other words, whether the policy decision to reach out to a more significant number of beneficiaries has enabled the support to those groups most affected.

• The economic measures taken during the early stages of the COVID-19 pandemic (when the Government declared a State of Emergency when there were only a few imported cases of COVID-19 and no community transmission) need to be adequately evaluated in terms of their appropriateness and proportionality, especially as these measures had significant negative impacts on the economy, which is now almost at the point of collapse, while at the same time the cases of COVID-19 are increasing.

Inclusiveness of Policies/Measures, Planning, and Implementation

The original demand for external funds (aid or loan) was inclusive, as the request strongly prioritised social protection (based on the assumption that the country would need to protect vulnerable groups if it entered lockdown). However, at the time of allocating these funds, social protection became secondary. Hence, implementing policies is at significant risk of not being inclusive in prioritising the protection of vulnerable groups.

This lack of inclusion is also noted in the weak, unequal, and inefficient allocation of funds to the provinces, with priority given to the central level. Therefore, an equity-accountability assessment of the COVID-19 budget plan should be conducted concerning the allocation of funds to the provinces because, historically, the central level has not prioritised allocating funds to promote inclusion and reduce urban–rural or province-central structural inequalities.

Inclusive policies that promote a better understanding of the State-citizen relationship were also relevant. The rationale behind the public debate, in which the public was partially blamed for the substantial increase in COVID-19 cases, needs to be further understood and clarified, especially in terms of the State’s role in formulating policies to ensure that the population can exercise their right to health. For instance, the fact that public transportation investments were not prioritised in the Government’s budget for the COVID-19 Response Plan weakens the responsibility of poor/low-income workers, who do not have any other option than to take an overloaded bus to work every day.

As pointed out above, the lack of inclusion is also present in the shift of priorities, from social protection policies to other areas, which did not aim to directly benefit the poor or tackle the specific needs of vulnerable groups.

An inclusive approach also needs adequate and transparent mechanisms for decision-making regarding the criteria for the prioritisation of vaccines. As noted by the CDD (CDD, 2021b), as the first batch of vaccines arrived in Maputo, the Ministry of Health is called on to disseminate the vaccination plan to inform public debate openly.

Participatory Mechanisms of Communication and Consultation

The Government’s decision-making mechanisms about the COVID-19 pandemic failed to include civil society stakeholders and lacked official consultation mechanisms, including a CSO representative in the COVID-19 Technical-Scientific Committee. This Committee did not establish a formal communication channel with the public, CSOs or CBOs, nor did it conduct press conferences, as expected. It was established without the composition or structure to be robustly inclusive in terms of representation, and it lacked a participatory mechanism to generate the lessons that the Government would need to be able to enhance knowledge based on the local context, which is necessary to deal with the current COVID-19 pandemic, as well as future crises. With an overall and detailed content that still requires further analysis, the letter of resignation of Professor Helder Martins from the role of a member of the Scientific Technical Commission for Prevention and Response to the COVID-19 pandemic on February 16, 2021, (Martins, 2021) (Res. of the Council of Ministers no 20/2020, of March 25th) reinforces, among other things, that politicians cannot manage an epidemic and that the opening of the Commission to society and the media could have helped to prevent fake news, circulated on social networks, causing panic in the population.

In terms of effective participation, CSOs expected that the Government would have learnt from past experiences (i.e., Agenda 2025) and established a Committee to connect diverse sectors, from national to local stakeholders, including channels for shared information and data gathering on the needs and context-specific impact of COVID-19 on the most vulnerable populations. On the contrary, the CBOs consulted lacked access to information on the planned social protection policies, which prevented them from exercising their role and supporting the Government in implementing local level actions to prevent and mitigation of the impacts of COVID-19.

This case study showed that analysing the policy coherence and equity of the COVID-19 response in Mozambique goes far beyond the current pandemic context and concerns the country’s ability to deal with crises in general. During the current crisis, civil society organisations have been active and willing to engage in inclusive governance, which requires efforts from all sectors. Likewise, international cooperation and private sector actors have supported government policies, despite the lack of confidence generated by the ‘hidden debts’ scandal.